Muscle Diseases

Question 1

how do muscles diseases typically present?

Answer 1

myalgia
muscle weakness
stiffness
abnormal bloods

Question 2

name the 2 inflammatory myopathies

Answer 2

polymyositis

dermatomyositis

Question 3

most common age to be affected by an inflammatory myopathy

Answer 3

40-50 years

Question 4

features of inflammatory myopathies on muscle biopsy

Answer 4

muscle fibre necrosis
degeneration
regeneration
inflammatory cell infiltrate

Question 5

is muscle weakness usually symmetrical or asymmetrical?

Answer 5

symmetrical

Question 6

what is gottrons sign

Answer 6

symmetric, occasionally scaling, violaceous erythematous eruption over the extensor surfaces of the metacarpophalangeal and interphalangeal joints of the fingers

Question 7

which muscle disease is associated with a heliotype rash?

Answer 7

dermatomyositis

Question 8

GI effects of dermatomyositis

Answer 8

dysphagia

Question 9

CV effects of dermatomyositis

Answer 9

myocarditis

Question 10

lung effects of dermatomyositis

Answer 10

ILD

Question 11

which muscle disease is most likely to get malignancy?

Answer 11

dermatomyositis

Question 12

most common malignancies to arise in muscle disease

Answer 12

ovarian
breast
stomach
lung
bladder
colon

Question 13

presenting symptoms of dermatomyositis

Answer 13

tired muscles
functional difficulty
raynauds
weight loss
cough
breathlessness
muscle pain

Question 14

what is confrontational testing?

Answer 14

direct testing of power eg pushing arm down while they resist

Question 15

what is isotonic testing

Answer 15

30 sec sit to stand test

Question 16

blood tests used in polymyositis?

Answer 16

CK
inflammatory markers
electrolytes, calcium, PTH, TSH
ANA, Anti-Jo-1

Question 17

what is CK

Answer 17

a muscle enzyme

Question 18

what is electromyography

Answer 18

increasing fibrillations, abnormal motor potentials, complex repetitive discharges

Question 19

diagnostic techniques for myositis

Answer 19

muscle biopsy
MRI
EMG

Question 20

treatment for myositis

Answer 20

glucocorticoids
azathioprine
methotrexate

Question 21

most common misdiagnosis for inclusion body myositis

Answer 21

polymyositis

Question 22

presenting feature of inclusion body myositis

Answer 22

distal muscle weakness

Question 23

why is inclusion body myositis called this?

Answer 23

inclusion bodies on biopsy

Question 24

are CK levels higher in inclusion body myositis or polymyositis

Answer 24

polymyositis

Question 25

age group affected by polymyalgia rheumatica?

Answer 25

over 50s

Question 26

which areas of the world most commonly get it

Answer 26

northern countries

Question 27

what disease is polymyalgia rheumatica commonly associated with?.

Answer 27

temporal arteritis/giant cell arteritis

Question 28

clinical presentation of polymyalgia rheumatica

Answer 28

morning stiffness that improves throughout the day ache in shoulder/hip symmetrical "cant get out of bed"

Question 29

clinical presentation of the arteritis that follows polymyalgia rheumatica

Answer 29

headache scalp tenderness jaw claudication visual loss (if optic artery damaged)

Question 30

does inclusion body myositis affect the distal muscles?

Answer 30

yes

Question 31

does polymyositis affect the distal muscles

Answer 31

no, affects proximal

Question 32

which inflammatory markers are raised in polymyalgia rheumatica

Answer 32

raised ESR, plasma viscosity, CRP

Question 33

treatment of PMR?

Answer 33

very good reaction to low dose steroids | if arteritis, higher dose

Question 34

who commonly gets fibromyalgia

Answer 34

women of child bearing age

Question 35

what causes fibromyalgia

Answer 35

depression | stress

Question 36

clinical presentation of fibromyalgia

Answer 36

``` muscle stiffness pain muscle tension fatigue trouble sleeping chest pain headache cognitive difficulty worse on exertion ```

Question 37

what pathogenic processes occur in fibromyalgia

Answer 37

hypersensitivity to pain

Question 38

associated conditions to fibromyalgia

Answer 38

depression | IBS

Question 39

treatment for myalgia

Answer 39

antidepressants strong analgesics eg gabapentin, pregabalin, mild opiates physio/OT/cognitive behavioural therapy

Question 40

elderly man with heavy feeling in arms struggling to climb stairs with a high CK

Answer 40

polymyositis